Gluten Sensitivity and the Gut Microbiome

Although this is a section for gluten sensitivity, there are some resources that mention celiac. Celiac is an auto-immune disorder, so also consult the autoimmune disorder section for resources (under Health Impacts).

Celiacs often have cross-reactivity to other foods and are prone to other autoimmune disorders.

The problem might not be gluten. My niece can eat sourdough bread made from stone ground Red Fife flour but not any bread made from commercially milled flours which heat the flour and may change its chemical make-up. Some can tolerate older varieties such as Einkhorn and Spelt.

How Common is Gluten Sensitivity?
I’ve long suspected that everyone has some degree of sensitivity to gluten, even if they’ve never been formally diagnosed and even if they don’t notice any overt symptoms after eating it.

Now we have concrete evidence that non-celiac gluten sensitivity actually exists. My own story was that of a lifetime grain-eater who defended my “right” to eat grains until I was 47 – until the evidence was just too overwhelming to ignore. Once I gave them up as part of a 30-day experiment, lo and behold, my arthritis cleared up, my lifelong IBS went away, and my occasional GERD disappeared. Ditching grains, especially wheat, changed my life for forever and made me understand how easy it is for so many people to overlook this possible problem. A recent study, which I highlighted in Weekend Link Love, confirmed the existence of non-celiac wheat sensitivity.

It’s not even the only study.
Still think gluten sensitivity isn’t real?
Catchy media headlines often poke fun at gluten sensitivity, and a considerable percentage of the population, including many doctors, still do not believe that non-celiac gluten sensitivity is real.

Yet many people without celiac disease feel better with a gluten-free diet. A recent study may have settled the debate once and for all. While the scientific community has widely accepted celiac disease as a condition caused by gluten and other related proteins, non-celiac gluten sensitivity has remained a topic of heated debate in the media and among the general public. In this article, I’ll talk about the reasons I have acknowledged non-celiac wheat sensitivity as a real condition for many years, and I’ll describe the results of a new research study performed at Columbia University that adds supportive evidence.

This is a post from the Gut Critters blog that ended November 18, 2016. Ray Medina gave permission for his material to be copied as long as it was attributed to him and not used for commercial purposes. – kiraonysko

Is gluten really the culprit in gluten sensitivity. What is Gluten? What Are The Issues With Consuming Wheat?
Does not everyone love to eat bread?

Nothing, is better then the smell of a fresh loaf of bread baking in the oven. Who does not miss eating a good slice of pizza if you have given up gluten? Occasionally, if your gastrointestinal system is in optimal shape, eating a slice of bread or pizza now and then might not hurt you. But for a lot of people with gastrointestinal issues, continuous or even acute consumption of gluten does damage to their digestive tract.
How Long Does it Take the Gut to Repair after Gluten Exposure? - The Paleo Mom. This is a very relevant question for those who are just embarking on their gluten-free journey.

But, it’s also extremely important for anyone who has been following a paleo/primal/gluten-free diet for a while, but has been inadvertently exposed to gluten. It sometimes feels as though the longer we avoid gluten, the more sick we feel after accidentally eating some. This is in large part because the body stops protecting itself from gluten (for example, there may be less mucus in the gut) so when we do consume some, we are defenseless.
Gluten Cross-Reactivity: How your body can still think you’re eating gluten even after giving it up. - The Paleo Mom.

For those 20% of us with celiac disease or gluten-intolerance/sensitivity (whether diagnosed or not), it is critical to understand the concept of gluten cross-reactivity.

Essentially, when your body creates antibodies against gluten, those same antibodies also recognize proteins in other foods. When you eat those foods, even though they don’t contain gluten, your body reacts as though they do. You can do a fantastic job of remaining completely gluten-free but still suffer all of the symptoms of gluten consumption—because your body still thinks you are eating gluten. This is a very important piece of information that I was missing until recently. Proteins are made of long chains of amino acids (small proteins may only be 50 amino acids long whereas large proteins may be 2000 amino acids long) and it is the specific sequence of these amino acids that determines what kind of protein is formed.
Gluten Cross-Reactivity UPDATE: How your body can still think you’re eating gluten even after giving it up. - The Paleo Mom. In my research for The Paleo Approach, I feel that it is important to provide scientific references for every single statement I make.

This has me doing a great deal of fact checking, scouring the medical literature to verify information often gleaned from other paleo authors and bloggers. Most of the time what I find out just helps reinforce concepts, filling in blanks, and typically making a strong case for my assertions.
Top 5 reasons for persistent symptoms after going gluten free.

If that sounds like an extremely broad description, that's because it is. The word "syndrome" is medicalese for "we don't know what causes it.
" IBS seems to be a catch-all for various persistent digestive problems that aren't defined as separate disorders, and it has a very high prevalence: as high as 14 percent of people in the US, although the estimates depend on what diagnostic criteria are used (1). It can be brought on or exacerbated by several different types of stressors, including emotional stress and infection. Maelán Fontes Villalba at Lund University recently forwarded me an interesting new paper in the American Journal of Gastroenterology (2). During the six weeks of the intervention, patients receiving the gluten-free food fared considerably better on nearly every symptom of IBS measured.

Differentiating Gluten Related Disorders. The Conundrum of Gluten Sensitivity and Autoimmunity - Why Tests are Often Wrong. US perspective on gluten related diseases. The influence of a short-term gluten-free diet on the human gut microbiome. We investigated the role of a four-week GFD on microbiome composition in healthy individuals and identified moderate but significant changes in their microbiome compositions and even stronger effects on the imputed activity levels of bacterial pathways.

On a taxonomic level we identified eight bacteria that change significantly in abundance on GFD: Veillonellaceae, Ruminococcus bromii, and Roseburia faecis decreased on GFD, and Victivallaceae, Clostridiaceae, ML615J-28, Slackia, and Coriobacteriaceae increased on GFD. The strongest effect was seen in the decrease of Veillonellaceae during GFD, Gram-negative bacteria known for lactate fermentation.

This is the first time that the Veillonellaceae family has been associated to a dietary intervention, but it was recently shown to be decreased in autistic patients [38]. Remarkably, the patients in that study were more often on a GFD (9/10) than the control group (5/10).
Video: Gluten Free Eating: Fading Trend or New Norm? – Nutrition QED. I’ve written a 4 part series about gluten that goes into great detail about what gluten is, what it does in the body, prevalence of gluten sensitivity and who should avoid it (part 1 is here).

If you want the full story about gluten, I recommend reading those posts. However, if you want a quick overview or prefer watching information to reading it, this video gives you an explanation of how gluten impacts the intestines (and how it causes leaky gut), the 3 reasons this is a problem, and how to figure out if you have gluten sensitivity. If you are interested in figuring out if you have any food sensitivities, consider joining one of my group programs or working with me directly.

Also, I am planning to do several more short talks like this, and I get to pick the topics. If you have a topic, you’d like me to cover, leave me a comment below and let me know.
Gluten Sensitivities and Bacteria. Science news has a recent article entitled “Microbiome Changed by Gluten Increases Incidences of Type 1 Diabetes“, since gluten sensitivities is common with CFS and there are similarities to Type-3 diabetes, I thought that I should drill down on this via PubMed.

First, it looks like there may be a probiotic to help in the works [2013]. For celiac disease, we appear to have lower Lactobacillus and Bifidobacterium species/ volume [2012] — which suggests that Lactobacillus Reuteri and Align (Bifidobacterium infantis 35624) has the potential to be helpful. Another 2013 studies suggests that high Bacteroidetes (phyla) and Parabacteriodes (genus) may be a factor.

The likely missing bacteria are Rothia bacteria according to this [2011] study (there is already a patent filed on such use), however there appear to be no commercially available probiotics.
Non-celiac gluten sensitivity triggers gut dysbiosis, neuroinflammation, gut-brain axis dysfunction, and vulnerability for dementia.
Gluten Free, But not Suitable For Celiacs: Milk, Chocolate, Corn, Instant Coffee and 20 Other Foods & Food Ingredients That Could Cross-React With Gluten Anti-Bodies - SuppVersity: Nutrition and Exercise Science for Everyone.

The Link Between Gallbladder Disease and Gluten Sensitivity - The Paleo Mom. (Created as a guest post for Paleo Parents.) Celiac disease is estimated to affect approximately 1 in every 100 people, but only 5% of these people receive a positive diagnosis 1. This is, in part, because celiac disease often doesn’t present with what are thought of as the classic symptoms (abdominal pain, bloating, intermittent diarrhea, weight loss). In fact, more often, celiac disease presents as a collection of symptoms that many physicians don’t associate with the disease (irritability or depression, anemia, stomach upset, joint pain, muscle cramps, skin rash, mouth sores, dental and bone disorders such as osteoporosis, neuropathy, and/or micronutrient deficiency) 2. However, the recognition and understanding of celiac disease is improving and more and more people with the disease are receiving positive diagnoses.

Fibromyalgia And Non Celiac Gluten Sensitivity. Sensitivity to wheat, gluten and FODMAPs in IBS: facts or fiction?
Abstract IBS is one of the most common types of functional bowel disorder. Increasing attention has been paid to the causative role of food in IBS.
Study Says: Wheat Belly is All in Australians' Head. And in Fact, the Peer-Reviewed Scientific Evidence for Non-Celiac Gluten-Sensitivity is Scarce, But Probably Not Non-Existent - SuppVersity: Nutrition and Exercise Science for Everyone. A recent study from the CSIRO Food Futures National Research Flagship and the University of Adelaide says: The data indicate that many adult Australians are consciously avoiding consumption of wheat foods, predominantly without any formal diagnosis. Reported symptoms suggest a physiological but not allergenic basis to this behavior. Can this be? Can your "gluten intolerance" really be in your head? Certainly it can, it's what scientists call a nocebo effect: A situation, where a harmless substance taken by a patient is associated with harmful effects due to negative expectations or the psychological condition of the patient.

But wheat is no harmless substance, right? Certainly not.
Canker Sores, Cold Sores: A Connection To Gluten?
The Celiac MD Articles - Amy Burkhart M.D., R.D. Microbiome Study Holds High Hopes for Celiac Prevention. Over 100 infants at risk of developing celiac disease have been registered in an international study that aims to solve the mystery of how the autoimmune condition occurs – and then stop it in its tracks. “By studying the microbial communities in the gut and various environmental factors, we hope to create a complete enough picture to eventually prevent celiac disease before it begins,” said Dr. Alessio Fasano, the director of the Center for Celiac Research and Treatment at Boston’s MassGeneral Hospital for Children, who is one of the lead researchers.

“We are learning more every day about the role the microbiome plays in maintaining the balance between health and disease,” he said in reference to the abundant microorganisms that inhabit our bodies, and are already offering clues to diseases such as asthma and diabetes. Officially called the “Celiac Disease, Genomic, Environmental, Microbiome and Metabolomic Study,” or CDGEMM, the joint U.S.
The Microbiome and Celiac: A Bacterial Connection. The gut microbiota influences celiac disease. Thirty-three percent of people have a gene that predisposes them to celiac disease (CD), while only two to five percent of the population will receive a diagnosis of the condition.

Elena Verdú, Associate Professor and researcher at McMaster University in Canada, wants to know why the unlucky minority end up with the disease. “We know that genes are necessary, but they’re not sufficient,” she says. “So there are other environmental factors that may play a role.” In a person with CD, gluten triggers a complex set of processes in the body. The small intestine is the site of all the action: when enzymes begins to break down gluten proteins from the diet, the immune system goes on high alert.

Verdú suspects the gut microbiota might be able to affect the immune reactions involved in celiac disease. She then wondered: Would changing the gut microbiota make the disease get better or worse?
Celiac and Other Autoimmune Disorders. In celiac, immune cells fight ferociously against a crumb of bread, damaging the small intestine in the process.
Bacteria from celiac patients influence gluten’s digestion and its ability to provoke an immune response - Gut Microbiota for Health. Cooling Inflammation: Celiac, Gluten and Trypsin Inhibitor. Summary Forget the gluten.
Has Antibiotic Overuse Caused A Celiac Disease Epidemic?
Common yeast may trigger celiac disease onset — The American Microbiome Institute.

Celiac disease is a serious autoimmune disorder in which gluten, found in wheat, rye, and barley, triggers an immune response that damages the absorption capabilities of the intestines.
Whole Health Source: Celiac and Fat-Soluble Vitamins. One of the things I've been thinking about lately is the possibility that intestinal damage due to gluten grains (primarily wheat) contributes to the diseases of civilization by inhibiting the absorption of fat-soluble vitamins.
The microbiome affects celiac severity in mice — The American Microbiome Institute. Does gut microbiota richness matter in celiac disease?
A recent study of humans with celiac disease who were treated with helminths raised the possibility that an increase in microbial species richness (i.e. the number of different species present) could regulate gluten-induced inflammation in the gut.

In general, studies indicate that a rich and diverse microbiota is a healthy one. But is richness the only thing that matters when it comes to the microbiota’s effects on the immune system in celiac disease?
Gut microorganisms cause gluten-induced pathology in mouse model of celiac disease: Early exposure to antibiotics, resulting in microbial imbalance, exacerbates response to gluten, according to research. Treating celiac disease with bacteria? — The American Microbiome Institute. Probiotics as adjuvant therapy in coeliac disease?
Einkorn.com - Buy Einkorn Wheat Berries and Flour, Recipes and Research.

Can hookworms fight against celiac disease? — The American Microbiome Institute. Helminths suppress the immune system by modulating the gut microbiota — The American Microbiome Institute. Dear Mark: Aloe Vera for Leaky Gut, One Meal a Day, and Glyphosate and Celiac Disease. Effect of Gliadin on Permeability of Intestinal Biopsy Explants from Celiac Disease Patients and Patients with Non-Celiac Gluten Sensitivity.